Should I see a dietitian, nutritionist, or GP?
Dietary advice is all around us. It's on the internet, in books, in commercials and on popular television weight-loss shows. But, despite having more access to this information than ever before, our waistlines continue to expand.
According to the Australian Institute of Health and Welfare
, three in five Australian adults and one in four children are now overweight or obese. That's millions of Australians at greater risk of developing cardiovascular disease, Type 2 diabetes, some musculoskeletal conditions and certain types of cancer.
For effective nutritional information for health, weight management and disease prevention, it's important to seek out the experts in the field. But with so many titles and qualifications to choose from, it's not always easy to assess who is best qualified or suited to your needs.
In Australia, nutritional practice is not government regulated, so anyone can use the title 'nutritionist' and 'dietitian' without the necessary qualifications. Therefore, looking for an expert with accreditation from a governing body such as the Dietitians Association of Australia (DAA) is the best place to start .
For effective nutritional information for health, weight management and disease prevention, it's important to seek out the experts in the field.
Accredited Practising Dietitian
Accredited Practising Dietitians or APDs are qualified nutrition experts, with a university education in human nutrition and dietetics. They can help you achieve healthy eating habits, weight-loss goals and disease management or prevention.
An APD can develop eating plans tailored to suit your preferences, lifestyle and medical history, and provide ongoing support, expert advice and guidance. They can work in conjunction with your GP and are also qualified to provide nutrition advice for many dietary-related conditions such as obesity, diabetes, food allergies, cancers and gastro-intestinal diseases.
When choosing a dietitian, look for the title Accredited Practicing Dietitian (APD), which means they have been accredited by the Dietitians Association of Australia (DAA) and are bound by its Code of Professional Conduct. Dietitians must be eligible to be a member of the DAA if they work in a hospital.
To become an APD, the dietitian must have completed a tertiary-level course approved by the DAA, which can include a Bachelor of Science degree followed by a one-to-two year postgraduate diploma or Masters degree, or a four-year integrated undergraduate course.
The cost of seeing a dietitian may vary depending on their experience and specialisation but may range from around $100-$150 for an initial consultation and $70-$90 for follow up sessions.
"APD is the only national credential recognised by the Australian Government, Medicare, the Department of Veterans Affairs and most private health funds as the quality standard for nutrition and dietetics services in Australia," says Accredited Practising Dietitian Dr Kellie Bilinski.
If you're referred to a dietician by your GP you may be entitled to a Medicare rebate of $52.95 per visit for five visits each year. Health rebates are also available from most private health insurers; check your health fund's website to see what they cover.
For a list of current APDs, visit the DAA website
Advanced Accredited Practising Dietitian.
According to the DAA, the title of Advanced Accredited Practising Dietitian (AdvAPD) is awarded to an Accredited Practicing Dietitian who is a "proactive leader who integrates high-level nutrition and dietetic skills to generate new knowledge to influence the health of the community".
The recognition program uses a competency-based assessment process, where APDs are required to meet established criteria in the areas of leadership and influence, professional competence, research and evaluation, education, supervision and mentoring, and strategic and reflective approaches.
Fees for AdvAPDs vary and like APDs, are set by the individual practitioner.
Accredited Sports Dietitian
An Accredited Sports Dietitian (ASD) provides diet and nutrition advice to help clients achieve their personal sporting goals. Sports Dietitians are qualified to advise athletes on areas such as hydration, supplementation, nutrition for competition and increased performance, and optimising body composition.
A nutritionist will usually have completed a tertiary qualification in fields such as nutrition, food science and public health and is qualified to provide expert advice to the general public on nutrition, safety and the health benefits of food. However, there's not a lot of regulation in regard to using this title and technically speaking, anyone can call themselves a 'nutritionist'.
Unlike dietitians, nutritionists generally do not provide one-on-one consultations and aren't qualified to provide medical nutrition therapy or clinical nutrition advice in hospitals. Nutritionists are generally employed in roles such as health promotion officers, community development officers, quality and nutrition coordinators, and food technologists.
The Nutrition Society of Australia (NSA) has a voluntary Register of nutritionists, which identifies professionals "with designated qualifications, who abide by the highest standards of professional conduct and the NSA Code of Ethics, and who are committed to on-going training and professional development".
Levels include an Associate Nutritionist (ANutr) for those with a bachelor's degree majoring in nutrition or equivalent, and Registered Nutritionist (RNutr) for those who meet Associate Nutritionist criteria and have three years of nutrition-related experience and/or study.
Specialist registration in animal nutrition (RAnNutr) and public health nutrition (RPHNutr) is also available.
You may also come across the title Accredited Nutritionist (AN). Until earlier this year, AN was an accreditation given by the DAA to nutritionists with the necessary tertiary education and expertise in a range of nutrition services. However, earlier this year DAA decided that it would no longer be awarding the AN credential to people who are non-dietetically trained. All APDs may use the title Accredited Nutritionist as they are eligible and will often use the title if it is more appropriate to their job.
A weight-loss consultant advises clients on motivation, weight loss and healthy living, and may be employed by a weight-loss company or work independently. Anyone can call themselves a weight-loss consultant without any formal training, though weight-loss companies will generally provide training to their staff, in line with the company's methodologies.
Certification for weight-loss consultants is available and includes a minimum of 12 months of study through an organisation such as the Australian Weight Loss Centre, with units in human behaviour, nutritional science and weight management.
While a weight-loss consultant may be a useful support for someone losing weight, a CHOICE shadow shop found that some weight-loss clinics were handing out unhelpful dietary advice, such as shunning fruit and dairy, and one company even told one of the shoppers: "Exercise will not help you lose weight."
If you like the idea of having weekly support, choose an organisation that is a member of the Weight Management Council of Australia which requires a rigorous assessment for accreditation. Weight Watchers Australia and Jenny Craig are members of the council.
If you're looking for general information on how to live a healthier lifestyle, your local GP is a good first step - particularly if money is a barrier to seeking help.
"In order to get good nutritional advice you don't need to see a dietitian," says Dr James Best. "You are going to get good general nutritional advice from a GP."
In order to help health practitioners, such as GPs, deal with the obesity epidemic, in 2013 the National Health and Medical Research Council (NHMRC) updated the Clinical Practice Guidelines for the Management of Overweight and Obesity in Adults, Adolescents and Children in Australia. The guidelines made recommendations such as measuring weight circumference along with BMI, conveying the message that even small amounts of weight loss can improve wellbeing, and referring appropriately when necessary.
"GPs will have a general understanding of the principles [of nutrition] and are also able to put it in the context of other health issues," says Dr Best. However, "a dietitian has a much more specialised training in nutrition, so they certainly are a good idea in situations where nutrition is very important, such as diabetes".
If you require more specialist nutritional advice, your GP will be able to refer you to a qualified nutrition expert, such as a dietitian or diabetes educator, where Medicare and health insurance rebates may be available.
Other avenues for dietary advice
The practice of naturopathy is a holistic approach to health using gentle therapeutic techniques such as herbal medicine, flower essences, lifestyle techniques and nutrition to promote balance in the body.
In conjunction with your GP, naturopathy can be useful, but make sure you choose a naturopath accredited with the Australian Natural Therapies Association (ANTA).
Naturopathy rates will vary but they may charge up to $250 for an initial consultation and up to $150 for a follow-up. Certain health extras
insurance policies will allow you to claim for Naturopathy. Check your policy.
Diet and fitness go hand-in-hand, so employing the services of a personal trainer for a personalised fitness plan is a positive step towards better health. Personal trainers in Australia are required to hold a minimum of Certificate III and Certificate IV in Fitness, which cover some basic nutrition training, so they may provide diet information as part of their consultation.